Asthma in Women, Asthma in Pregnancy (cont.)

Epidemiology: Who Gets Asthma? Is Asthma Different In Men and Women?

Among 5-24 year-olds, the risk of dying from asthma in 1993 was 1.5 times higher in men than women (2). Mortality from asthma in females in 1995 was 2.5 per 100,000, compared to 1.9 in males. 1998 American Lung Association estimates observed that asthma increased much faster in women than men, 42% vs. 81%, between 1982 and 1994.

In people aged 20-50, the ratio of women to men admitted to the hospital for asthma is 3:1 (2). In 1995, the rate of hospitalization for asthma in females was 22.4 per 10,000, vs. 16.5 in men (2). Women also had longer lengths of stay once admitted to the hospital, 4.1 vs. 3.2 days (2). It is thought that asthma may therefore be related to hormonal conditions. There is some research proof of this.

Asthma is more severe in women, especially in the childbearing years, than in men, and it may get worse during a woman's menstrual period, again suggesting a possible involvement of female hormones. Although asthma affects females more than males in general, during childhood the opposite is true (2).

In 1995, 52.6 women per 1000 population had asthma, compared to 52.6 in men (2). Females also have a greater use of emergency rooms for asthma, 82.3 vs. 57.8 per 10,000 in men vs. women in 1995 (2). These gender differences appear to be growing, not lessening.

Preliminary work suggests that woman may access outpatient care for asthma more frequently than do men, and that women in the emergency room for asthma may have a bigger chance of being admitted to the hospital compared to men. Also, of asthma patients admitted to the intensive care unit, females may have worse asthma (more severe disease) than do males. The reasons for these gender differences in asthma are not yet known. Since it has been reported that women use "rescue medications" (see treatment section below for description) more frequently than men do, the women may either have more severe asthma, may not be prescribed the daily maintenance medications as often as are men or may not be taking their controller medication.

Complications

Rarely, asthma can result in death. Asthma causes 5000 deaths per year (6). The asthma deaths occur mostly in blacks aged 15-24 years (2). It causes days of restricted activity and multiple hospitalizations each year.

Prognosis: How is Asthma Different in Pregnancy?

All women are different. The course that asthma will take when an asthmatic woman becomes pregnant is impossible to predict beforehand. Furthermore, there is research evidence suggesting that women with asthma are higher risk of having pre-term infants, low birth-weight infants, infants small for their gestational age, increased hospital stays, and other complications. There is strong medical basis to believe that the risk of using asthma medication in pregnancy is minuscule compared to the risk of NOT treating the asthma.